MEDICARE: ROBERT W MALIZIA MD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207P00000X	Emergency Medicine Physician	263906	NY

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1144426149
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ROBERT W MALIZIA MD

Provider Business Mailing Address
First Line	:	1551 RICHMOND RD
Second Line	:	SUITE 1A
City	:	STATEN ISLAND
State	:	NY
Zip	:	10304-2313
Country	:	US
Telephone Number	:	718-987-4891
Fax Number	:	718-987-4893

Provider Business Practice Location Address
First Line	:	1551 RICHMOND RD
Second Line	:	SUITE 1A
City	:	STATEN ISLAND
State	:	NY
Zip	:	10304-2313
Country	:	US
Telephone Number	:	718-987-4891
Fax Number	:	718-987-4893

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/26/2007
Last Update Date	:	07/06/2013

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Directions to “ ROBERT W MALIZIA MD” Practice Location

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